The Purple Book

IV, SC Furosemide

• a loop diuretic - inhibits tubular reabsorption of Na+ & Cl- in the proximal & distal tubules & thick ascending loop of Henle by inhibiting the Na-Cl cotransport system. Causes excessive excretion of water as well as Na, Cl, Mg and Ca especially after initial dose.
• useful in HF patients because of reduced oral absorption resulting from gut oedema
• diuresis following SC furosemide reaches max at 2-3/24 and lasts about 4/24

Cannula insertion

• Insert and secure the cannula (22g gauge, blue) in an area which can be 'pinched' to create a fold of skin comfortably
  • Choose an area: anterior upper chest or abdomen, outer aspect of upper arm or thigh
  • Avoid: areas with rash or possible infection/inflammation
• Cover with transparent, semi-occlusive dressing to allow for inspection.
• Secure tubing with omental method of taping to reduce chance of dislodging
• Connect prepared elastomeric pump connector tubing to cannula and release clamp.

omental method

Elastomeric pump setup

• Aseptic technique
• Close the clamp on the patient facing tube
• Open the comfort cap and take off filling port cap
• Prime the pump via the filling port with ‘x’ml saline (see below) and close both caps.
• Open the cap on the patient connector, keeping uppermost, and release the clamp until fluid appears
• Close clamp and then fill remaining volume with furosemide solution

Braun Elastomeric pump

VW SC furosemide guideline CUH 2023